What makes the ADA Members Insurance Plans different from other insurance?
As an ADA member, you leverage the significant volume buying power of the ADA, which sponsors the plan. The result is low, group rates available only to ADA members. More than 100,000 ADA members, student members and their families rely on ADA Members Insurance Plans for insurance protection each year.
Additionally, the favorable claims experience is shared with the participants in the form of a Premium Credit discount. The Premium Credit is a Plan-specific discount that reduces billed premium for all Plan participants, regardless of coverage amount. Premium Credit discounts are not guaranteed and may not be available on all Plans.
Great-West Financial has been protecting ADA members and their families since 1934. The long-term track record and relationship between the ADA and Great-West Financial gives you confidence that your ADA Members Insurance Plans protection will be there when you need it most.
How do I increase my coverage?
To get additional coverage under any of the Plans, complete an application. You can apply online or get an application and return it to Great-West Financial by fax or mail. Chat with a Plan Specialist online or call 866-607-5338 to request additional assistance in determining your insurance needs.
When can I increase my coverage?
To be eligible for additional coverage for yourself or any eligible dependents, you must be under age 60 (under age 65 for the Term Life, Level Term Life, Term Plus®, Critical Illness or Hospital Indemnity Insurance Plans) at the time of application. Certain other eligibility requirements will also apply to some Plans, and proof of insurability is required under most.
Any time there is a major change in your financial situation or personal circumstances (such as a new home or baby, practice expansion, or child in college), you should re-evaluate and probably apply to increase your insurance coverage. Also, if you meet with your accountant, attorney, or financial planner on an annual basis to discuss your overall finances, it's a good practice to include a review of your insurance situation.
If there is a guaranteed Future Increase feature on your disability certificate, you can automatically increase your coverage — without providing further proof of insurability — at certain policy renewal dates. You will be notified on your billing notice if you're eligible for such an increase, and all you need to do is pay the amount indicated. Your higher coverage will go into effect on the next premium due date.
How do I apply for Spouse or Child coverage?
Your Spouse or Domestic Partner under age 60 (under age 65 for Term Life, Level Term Life, Critical Illness, and Hospital Indemnity) and/or dependent children under age 21 (or to age 27 if they are full-time students) are eligible for two types of ADA-sponsored coverage — life insurance under the Term Life or Level Term Life Plans, and supplemental medical insurance under the Critical Illness and Hospital Indemnity Plans — as long as you are a participant in the same Plan and are eligible to apply for additional coverage.
You apply for dependent coverage on behalf of your family member(s), using the same application form you would use for Member insurance. Click here for a Term Life application, Level Term Life application, Critical Illness application, or a Hospital Indemnity application..
When you apply for coverage for your spouse or Domestic Partner, he or she will be asked to provide proof of good health as required by the Plan. Both of you must also complete and sign the application. If you request coverage for a Domestic Partner, you must also submit an Affidavit of Domestic Partnership signed by both parties. Upon termination of any Domestic Partnership, you will be asked to complete a Termination of Domestic Partnership form in order to terminate this coverage.
How long does it take to be approved?
It typically takes 8 - 12 weeks from the date your application is received until an underwriting decision can be made. However, application processing time can vary depending on the type and amount of coverage requested and the timely availability of your personal information.
You can make a big difference in helping reduce the time it takes to process your application. We appreciate your active involvement and cooperation. To expedite processing, please follow these pointers:
Please note: If you need proof of insurance specifically to provide collateral for a loan, we will do our best to expedite your application internally, and can provide your lender with documentation to support the loan approval process.
- Make sure your application is thoroughly completed — with all questions answered and all signatures provided — when you first submit it.
- Schedule your paramedical exam as soon as possible and keep your appointment.
- Notify your physician's office so they can begin assembling copies of your medical records. Follow up with them until your records have been sent.
- Submit copies of all required federal income tax returns and financial or legal documents along with your application. Financial underwriting requirements and an Affidavit of Domestic Partnership (if you are requesting coverage for your Domestic Partner) are available online.
Do I have to be an ADA member to keep my insurance coverage?
Yes. Because access to discounted group insurance is a major benefit of ADA membership, you are required to be an ADA member in good standing if you wish to continue your ADA-sponsored insurance. Some members say the savings they get on their insurance protection more than covers for the cost of ADA membership.
If I have health problems, can I still get coverage?
Possibly. Your ability to be approved for coverage will depend on the nature and severity of your medical impairment(s) and the type of coverage you're requesting. Some health problems that may not affect your insurability for one type of coverage could prevent you from acquiring another type of coverage. Regarding disability insurance, you may be offered coverage excluding a certain illness or condition, rather than being declined altogether. Because everyone's circumstances are different, contact an Insurance Plan Specialist at 866-607-5338 or email@example.com to discuss your health concerns and personal situation.
What is Proof of Insurability?
"Proof of insurability" refers to the written evidence that verifies you are insurable according to the general underwriting standards of the insurance company. Your proof of insurability is generally determined through medical and/or financial underwriting. Please note: Medical underwriting typically involves a paramedical exam (which is arranged at your convenience and at the Plan's expense), blood draw, and a report from your attending physician.
Insurance companies routinely gather information about applicants in order to evaluate each individual who applies for coverage. Every ADA Member who requests coverage through the ADA Members Insurance Plans is individually underwritten. But once you have provided acceptable proof of insurability to initially qualify for coverage, you can continue that coverage as long as each Plan allows, no matter what happens to your medical condition and/or financial circumstances thereafter.
What is Guaranteed Issue?
Insurance coverage that is guaranteed issue means no proof of insurability is required; as long as you meet all eligibility requirements, you are guaranteed to get the coverage — no questions asked — regardless of your medical or financial situation. Guaranteed issue coverage is most frequently offered in small amounts for a limited time and under exclusive circumstances (such as during dental school or upon first joining the ADA).
The main advantage of guaranteed issue coverage is that if you meet eligibility requirements, you cannot be turned down at the time you sign up. As long as you satisfy all eligibility requirements and pay premiums when due, you are guaranteed to get — and keep — the coverage according to the Plan's provisions. Even if your health deteriorates over time or your financial situation changes dramatically, you can continue to renew the coverage at your option until it expires. And any conversion privileges that exist under the Plan are fully available to you, also regardless of your medical condition.
ADA members may have access to some guaranteed issue coverage through the ADA Members Insurance Plans:
- The Critical Illness and Hospital Indemnity Plans guarantee basic levels of coverage to all members under 65 who enroll*. Even your spouse and/or dependent children can get core Critical Illness and Hospital Indemnity coverage on a guaranteed issue basis as long as you are also a participant in the Plan.
- Student members (including ASDA members) can get $50,000 in Term Life coverage and up to $2,000 in monthly Student Disability coverage on a guaranteed issue basis, depending on when enrollment takes place.
Great-West Financial will not pay for any confinement or treatment resulting from a condition for which the insured received any medical treatment, care, advice, or medication within 12 consecutive months before the effective date of this insurance and applicable to any insurance increases.
Critical Illness Insurance is guaranteed issue for coverage at $5,000 and less, meaning approval is guaranteed without any medical or financial underwriting. Benefits from $10,000 to the maximum of $50,000 ($5,000 minimum incremental increase) are subject to underwriting approval.
Hospital Indemnity Insurance is guaranteed issue for all eligible enrollees. You may select any Hospital Daily Benefit amount between $100 and $1,000 (in $50 increments only).
What is the Accidental Death option?
Accidental Death coverage pays an extra benefit if your death results from an accident as defined by the Plan. When selected, the amount of your Accidental Death benefit is the same as your life insurance benefit, up to a maximum of $1,000,000. For example, if you have $400,000 of life insurance in force and purchase the Accidental Death option, your beneficiary would receive a total of $800,000 (i.e., $400,000 basic benefit + $400,000 Accidental Death benefit) if your death was by accidental means. On the other hand, if your life insurance coverage is $1,500,000, then your beneficiary would receive a total of $2,500,000 ($1,500,000 + $1,000,000) in the case of your accidental death.
You can elect this optional coverage for your Term Life and/or Term Plus® Universal Life coverage. Enhancing your life insurance coverage with the Accidental Death option can add tremendous value to your insurance protection. Please note: If you elect this coverage, any of your dependents who are insured in the Plan will automatically have this extra coverage too.
What is the Waiver of Premium option?
The Waiver of Premium feature allows your ADA life insurance coverage to continue, without paying premiums, if you become totally and permanently disabled (unable to perform any occupation) before age 60. Your coverage will continue at full value until it expires, which occurs at age 81 for the Term Life Plan, and age 90 for the Term Plus Plan. And if you have Term Life coverage in force for any of your dependents, premiums for that coverage will be waived too.
You can elect this optional coverage for your Term Life and/or Term Plus Universal Life coverage. Enhancing your life insurance coverage with the Waiver of Premium option can add tremendous value to your insurance protection.
What is the Future Increase Option (FIO)?
The Future Increase Option (FIO), available on the Disability Income Protection Plan, enables you to increase coverage automatically without a medical exam. Increases of $1,000 every twelve months for a total of up to $5,000, can be exercised at renewal time (once per twelve-month period, exercised up to 5 times, subject to the Plan's current monthly maximum) by completing the documentation requested on your renewal notice and remitting the additional premium. This optional coverage feature may be requested until age 50 and exercised until age 55.
A similar feature is built into the Office Overhead Plan. The Future Increase Benefit is exercisable at any renewal time before you turn 55, with mechanics similar to the Disability Income Protection Plan: Increments are $500 each, for a total of up to $2,500 in additional monthly coverage (subject to the Plan's current monthly maximum). If you are eligible for an increase, you will be notified on your semi-annual renewal notice.
Would my ADA Members Insurance Plans disability benefits be reduced if I earn income outside of dentistry while I'm disabled?
No. Whether you are capable of earning income from other occupations (like teaching, consulting, or sales) or simply choose to work as a way to stay mentally or physically active, your monthly disability income benefits will not be reduced because of income earned from an occupation other than your area of dentistry. In fact, the Disability Income Protection Plan was enhanced so members can now receive full benefits regardless of any other income they choose to earn while disabled from dentistry. As a result, as long as you earn less than 20% of your pre-disability income from clinical dentistry (whether totally or partially disabled), you can be eligible for your full monthly benefit amount. This change illustrates the ADA's ongoing commitment to providing generous insurance protection and great overall value to members.
What does "Own Occupation" mean?
"Own occupation" is the basis used in defining disability coverage under the Disability Income Protection and Office Overhead Expense Plans. Own occupation coverage is the most generous type of disability insurance you can buy. It means that disability is determined by your inability to perform the duties of your specific occupation or profession. (If you are a practicing dentist performing clinical dentistry, then your occupation is the clinical practice of either general dentistry or one of the specialized areas of dental practice approved by the ADA, such as orthodontics or oral surgery.) That's important because your training and education have prepared you specifically for this profession, and if you can't practice dentistry because of a disability, you may be forced to change careers.
By contrast, "any occupation" disability coverage does not consider you disabled if you are still capable of performing the duties of any occupation for which you are reasonably suited, such as teaching, consulting, sales, or administration. If you purchase "any occupation" coverage, you may not receive any cash benefits even though you cannot physically tolerate the rigors of active dental practice.
Own occupation coverage may be difficult to find, but both ADA-sponsored disability insurance plans, the Disability Income Protection Plan and the Office Overhead Expense Plan, automatically include own occupation coverage for all participants.
In fact, under the Disability Income Protection Plan, you can receive full own occupation benefits all the way to age 67, regardless of your age at time of disability, and regardless of any other income you choose to earn while disabled from dentistry. (Other policies may offer own occupation coverage for two or five years at most; then "any occupation" definition usually determines your eligibility to continue receiving benefits. Still other policies may offset, or reduce, the dollar amount of benefits you receive as a result of income you earn from other sources, like teaching or consulting.) Under the ADA Plan, full own occupation benefits can be payable all the way to age 67 (or for up to two years if you become totally disabled between ages 65 and 75) without any offsets for other income. And rates for ADA disability coverage can be significantly less than other disability insurance.
If you're shopping around for the best disability insurance, consider the impact that an own occupation definition could have on your potential to receive benefits. Dentists are uniquely prone to many types of physical disabilities, and statistics show you have a 1 in 4 chance of becoming disabled long enough to collect benefits at some point in your career before retirement.* If your family's standard of living relies on your ability to earn income as a dentist, you may decide that it's well worth purchasing the most generous own occupation coverage available.
*Odds of disability determined by Great-West Life in 2014 after studying years of disability claims by ADA members.
How long does your "own occupation" coverage last?
In both ADA-sponsored disability plans, your own occupation coverage can be renewed until age 75, providing you with one of the most generous types of disability coverage available. As long as you satisfy all eligibility criteria, the duration of benefits varies by Plan as described below.
Under the Disability Income Protection Plan, full own occupation benefits (with no offsets for income you choose to earn in another occupation while disabled from dentistry) can be paid all the way to age 67, no matter when your disability begins. If you become disabled between ages 65 and 75, you can receive up to two years of own occupation benefits.
Under the Office Overhead Expense Plan, you can receive own occupation benefits up to 12 or 24 times your monthly insured amount (depending on which Benefit Plan you select) for covered expenses incurred within 48 months of the date you first become disabled. Concerning the 24 times benefit, it is payable prior to age 70; however, if disability occurs between ages 70 and 74, the benefit changes to 12 times the insured amount. Concerning the 12 times benefit, it is payable prior to age 75.
When are premiums due?
Renewal premiums are billed either semi-annually or annually for life insurance Plans, based on the option you elect, and semi-annually for all other Plans. When you initially purchase coverage, you will receive an interim bill for the interim period until the next regular policy renewal date. You will subsequently be billed along with all other Plan participants according to your Plan's billing schedule. Billing notices may be mailed to any address you specify.
Premiums are billed about 30 days in advance of the renewal date, which provides ample time for you to remit payment by the due date. Delinquent payments received within 30 days after the renewal date will still be accepted, although coverage will go into lapse status on the 31st day after the due date and ultimately be terminated if payment is not received timely. To keep your coverage in force, please be sure to pay your premiums on time. Our reinstatement policy will apply if your coverage is terminated as a result of a late or absent payment.
Instead of receiving a billing notice through the mail, you can elect Autopay as a convenient, alternative billing option. Autopay enables you to pay premiums, either semi-annually or monthly, via pre-authorized automatic bank withdrawal. Your premiums are automatically deducted from your bank account, and your coverage renews automatically, too.
What should I do if I don't get a bill?
If you are expecting a bill but don't receive one, please contact us at 800-568-2001 or firstname.lastname@example.org as soon as possible. You are still responsible for paying premiums when due. Your coverage must be renewed on time through full premium payment in order to stay in force. If your billing address has changed, please notify us as soon as possible.
Can I pay premiums over the phone?
Yes. Call 800-568-2001 to use our automated secure payment system. You can pay with MasterCard, Visa, American Express, Discover or electronic check. You can pay over the phone 24 hours a day, 7 days a week.
Can I pay premiums by credit card?
Yes. You have a choice to either pay your premiums online or by phone. With both options you can pay with MasterCard, Visa, American Express or Discover. Simply call 800-568-2001. Whether you wish to get extra miles or points, defer payment for a while, or take advantage of the financial reporting/budgeting services provided through your credit card account, this premium payment option gives you greater flexibility. There is no additional cost to you to pay your premium by credit card.
If managing your cash flow is your ultimate goal, you may prefer to make smaller, more frequent premium payments via the Monthly Autopay option. Offering you choices for premium payment, both in terms of renewal frequency and payment method, is another way we provide you with exceptional customer service. Learn more about your various payment options here or by contacting us at 800-568-2001 or email@example.com.
Can I pay premiums by automatic bank withdrawal?
Yes. Autopay allows your renewal premium to be automatically deducted from your bank account on a monthly or semi-annual basis for all Plans, and also on an annual basis for the Term Life Plan. Pre-authorization is required, but you can download an Autopay enrollment form and begin the process right away. Please note: A modest 2% charge applies to all monthly Autopay payments to help cover the costs of administering this payment option.
You can also pay premiums manually, after receiving your semi-annual or annual renewal notice, via any online bill-pay service such as that offered by your bank. Contact us at 800-568-2001 or firstname.lastname@example.org if you have any questions about electronic payment options.
How do Volume Discounts work?
Volume discounts of 2% or 4% are based on the amount of member life insurance coverage you have purchased. Coverage in both the Term Life Plan and Term Plus® Universal Life Plan counts toward your total, and if you qualify by having at least $1,000,000 of coverage, a volume discount will apply to whatever member and spouse life insurance coverage you have in force. If you qualify for a volume discount, it will automatically be deducted from your premium notice. Volume discounts are unlikely to change but are not guaranteed.
Do I qualify for preferred rates for life insurance?
Preferred rates are available to the healthiest individuals who have low-risk health and lifestyle characteristics. Your eligibility will be determined through medical underwriting.
Information that will be taken into account includes:
|Age ≤ 59
||Less than 140/85, no medication in last 2 years
|Age ≥ 60
||Less than 140/85, controlled with 1 medication
||Total cholesterol ≤ 220 with a Chol/HDL ratio ≤ 5.0
||Total cholesterol 221 to 295 with a Chol/HDL ≤ 4.0
No death of parents or siblings from coronary artery disease, cerebrovascular
disease or cancer prior to age 60
||No tobacco use for 5 years
||No DWI/DUI in last 5 years & < 3 moving violations in last 3 years
||BMI ≤ 29.9
||No hazardous sports/hobbies in last 2 years; recreational scuba diving to 75ft okay
||No hazardous foreign travel according to the U.S. travel advisories
If you qualify, Preferred rates will apply for a minimum of 10 years. At any time on or after your 10th anniversary, you may be asked to requalify for another 10 years by providing proof of good health satisfactory to the company. If you choose not to requalify or if your application to requalify is not approved, your coverage will automatically continue at the rate applicable to the Standard risk class. If the applicant does not qualify for Standard or Preferred rates, it may be possible to qualify for one of the two additional substandard rate classes.
How do Premium Credits work?
The ADA sponsors the program and the favorable claims experience is
shared with the participants in the form of a Premium Credit discount. The Premium
Credit is a Plan-specific discount that reduces billed premium for all Plan participants,
regardless of coverage amount. Premium Credit discounts are not guaranteed and may not be
available on all Plans.
As financial experience varies over time, the
Premium Credit for any Plan fluctuates accordingly. It is awarded in advance, meaning
rates are discounted at the time each premium is due, even for new participants.
Once you are approved for coverage, you are eligible to receive a Premium Credit
— regardless of your age, how much insurance you purchase, or how long you
have been covered.
Recently declared Premium Credit discounts for each Plan:
||Premium Credit Discount
Term Plus® Universal Life
Disability Income Protection
Office Overhead Expense
Hospital Indemnity Plan
Critical Illness Plan